Tom Price Is Eager to Lead H.H.S., and Reduce Its Clout

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Representative Tom Price, left, discussing a budget proposal in 2015. Mr. Price, a Georgia Republican, is President-elect Donald J. Trump’s nominee for secretary of health and human services.CreditDrew Angerer for The New York Times

WASHINGTON — During his 12 years in Congress, Representative Tom Price has made clear what role he thinks the government should play in health care. It can be summed up in one word: less.

Throughout his career, Mr. Price — who has been picked by President-elect Donald J. Trump to be secretary of health and human services — has argued that the government should get out of the way of doctors and give patients more control over their health care.

This position is rooted in Mr. Price’s experience as an orthopedic surgeon for more than 20 years. “As a physician,” he said in the House in 2007, “I know oh so well how the intervention of the state and federal government into the practice of medicine destroys the ability to take care of people. It makes it so you can’t provide quality health care for children and moms and dads.”

Though he has worked for years to shrink the government’s role, Mr. Price, a Georgia Republican, could soon lead a government agency whose expansive mission is to ensure care for more than 100 million Americans. As chairman of the House Budget Committee, he has tried to put a lid on federal spending. As secretary, he would be responsible for more than $1 trillion in spending, a number that will surge as the population ages.

The health secretary has immense discretion to impose, revoke and modify rules. A review of Mr. Price’s record in Congress, including his speeches and legislative proposals, suggests that he would try to reduce the burden of federal regulations on health care providers, especially doctors.

As secretary, he would be responsible for the popular Children’s Health Insurance Program, which insures eight million children at some point each year. In 2007, he opposed expansion of that program because, he said on the House floor, some children with private insurance would become eligible for “government-run socialized medicine.”

Two years later, as the House debated a huge bill to jolt the economy out of a severe recession, Mr. Price jumped to his feet after spotting an item that provided $1.1 billion for research comparing the effectiveness of different drugs and medical treatments. He denounced it, saying he feared that the findings would be used to decide which items and services would be covered by insurance.

“This is indeed the foundation of rationing of American health care for each and every American,” he said — a step toward Democrats’ dream of “nationalized health care.”

And in 2010, when Congress approved the Affordable Care Act, Mr. Price called it “a dark day for America,” saying that “our founders are weeping” over a bill that was “an affront to federalism, an affront to individual liberty.”

Senate Democrats are sure to challenge many of his positions at his confirmation hearings. Just as they distrust him on health care, he distrusts them.

“The true desire of those on the left,” Mr. Price said on the House floor in 2007, “is to gradually and enticingly move all Americans to Washington-controlled bureaucratic health care.” The bureaucracy, he said, is “not nimble like the private sector.”

Mr. Price, whose father and paternal grandfather were also physicians, is a fierce advocate for doctors. But he says his primary concern is for patients. A desire to “empower consumers” has been a theme of his work in Washington.

In 2010, he said on the House floor that he had discovered that “there were more folks in Washington who affected what I could do for and with my patients than anybody I ever met in residency or in medical school.” That, he said, “was wrong.”

Mr. Price often reminds colleagues of a sentence in the original Medicare law, passed in 1965: “Nothing in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine.”

“We violate this law all the time,” Mr. Price said in 2005, referring to the government, especially “the bureaucrats, nonmedical individuals,” who have written reams of rules defining the quality of care.

Mr. Price has opposed the Obama administration’s effort to require employers and insurers to provide free coverage of birth control for women, saying it threatens religious freedom. The government should not “define and control what constitutes health care,” he said in 2012, voicing a concern he has long expressed.

Women’s rights advocates say Mr. Price’s position on birth control is at odds with his antipathy to government interference in health care. Decisions about contraception, they say, should be left to women, in consultation with their doctors.

Soon after becoming a House member in 2005, Mr. Price introduced a resolution stating that Congress should move the nation toward a new model of health insurance, in which employers would give employees a certain amount of cash so they could buy insurance on their own, rather than enrolling in a health plan chosen by the employer.

“Moving from a defined-benefit system to a defined-contribution system,” he said, would have a big advantage for consumers: They would “own and control” their insurance policies.

“That is a sea change,” Mr. Price said. It means that “patients can vote with their feet” and go to a different insurer, regardless of whether the cost is paid by Medicare, Medicaid or an employer.

“Unleashing the power of choice and competition is the best way to lower health care costs and improve quality,” he said.

House Republicans, led by Speaker Paul D. Ryan, embraced this idea in their “Better Way” policy agenda, issued in June. Under their proposal, Medicare would offer a fixed amount of money for coverage of each beneficiary. The money could be used to buy private insurance or to pay for the traditional Medicare program.

Democrats have assailed this approach, saying it leaves older Americans to fend for themselves if they need care that costs more than the federal contribution.

Many of Mr. Price’s legislative proposals would affect the department he now hopes to lead. The stated purpose of one bill is “to restore to states the freedom and flexibility to regulate health insurance markets.”

The bill would roll back insurance standards prescribed in the Affordable Care Act. Women could again be charged more than men of the same age for similar insurance policies, unless states banned such practices. Some people with pre-existing conditions who allow their insurance to lapse could have difficulty obtaining affordable coverage in the future.

Under another one of his bills, consumers could receive tax credits to help pay for insurance, but for many lower-income people, the amount of assistance would be less than what they receive under the Affordable Care Act.

Residents of one state might be able to buy insurance more easily from companies in other states. For consumers willing to take more responsibility for the cost of their medical care, it would be easier to set aside money in tax-favored health savings accounts.

But people with high-cost employer-sponsored health coverage could face new taxes. And patients who believe they have been injured by negligent doctors could find it more difficult to win damages in court.

If confirmed, Mr. Price will have a chance to practice what he has preached for decades. He could try to overhaul what he calls the “predatory trial lawyer litigation system.” He could try to stop what he calls “regulatory oppression” by the federal government. And he could eliminate some of the mandates that he calls a “death knell for quality health care.”